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A rapid\u2010acting, easy to administer antidote is needed. We conducted a randomized control trial in swine comparing intramuscular administration of aminotetrazole cobinamide (2.9 mL, 18 mg\/kg) to no treatment following inhalation of H<jats:sub>2<\/jats:sub>S gas. We found that aminotetrazole cobinamide administered 2 min after the onset of respiratory depression\u2014defined as a tidal volume of less than 3 mL\/kg for 2 consecutive minutes\u2014yielded 100% survival, while all control animals died. Respiratory depression resolved in the treatment group within 3.6 \u00b1 1.5 min (mean \u00b1 SD) of cobinamide administration, whereas control animals had intermittent gasping until death. Blood pressure and arterial oxygen saturation (SO<jats:sub>2<\/jats:sub>) returned to baseline values within 5 and 10 min, respectively, of cobinamide treatment, and plasma lactate concentration decreased to less than 50% of the highest value by the end of the experiment. In control animals, plasma lactate rose continuously until death. We conclude that intramuscular aminotetrazole cobinamide is effective in a large animal, inhalational model of acute, severe H<jats:sub>2<\/jats:sub>S poisoning.<\/jats:p>","DOI":"10.1111\/nyas.14339","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T16:51:55Z","timestamp":1585673515000},"page":"159-167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Intramuscular aminotetrazole cobinamide as a treatment for inhaled hydrogen sulfide poisoning in a large swine model"],"prefix":"10.1111","volume":"1479","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-753X","authenticated-orcid":false,"given":"Tara B.","family":"Hendry\u2010Hofer","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine University of Colorado Denver \u2013 Anschutz Medical Campus  Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick C.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine University of Colorado Denver \u2013 Anschutz Medical Campus  Aurora Colorado"},{"name":"Brooke Army Medical Center Ft Sam Houston  San Antonio Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison M.","family":"McGrath","sequence":"additional","affiliation":[{"name":"Department of Environmental Health and Safety University of Colorado Denver \u2013 Anschutz Medical Campus  Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mukai","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute and Medical Clinic University of California Irvine  Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Brenner","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute and Medical Clinic University of California Irvine  Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sari","family":"Mahon","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute and Medical Clinic University of California Irvine  Irvine California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph K.","family":"Maddry","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center Ft Sam Houston  San Antonio Texas"},{"name":"59th Medical Wing\/Science &amp; Technology Lackland Air Force Base  Lackland AFB Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerry R.","family":"Boss","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego  La Jolla California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikhyat S.","family":"Bebarta","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine University of Colorado Denver \u2013 Anschutz Medical Campus  Aurora Colorado"},{"name":"Office of the Chief Scientist, US Air Force Reserve Joint Base San Antonio\u2010Lackland  San Antonio Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrestox.5b00015"},{"key":"e_1_2_9_3_1","first-page":"1277","article-title":"Hydrogen sulfide poisoning: review of 5 years' experience","volume":"117","author":"Burnett W.W.","year":"1977","journal-title":"Can. 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